Provider Demographics
NPI:1700273026
Name:BOWSER, LINDSEY LING (MD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LING
Last Name:BOWSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANN
Other - Last Name:LING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:220 SW 84TH AVE.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324
Mailing Address - Country:US
Mailing Address - Phone:904-308-7374
Mailing Address - Fax:904-308-2998
Practice Address - Street 1:220 SW 84TH AVE.
Practice Address - Street 2:SUITE 201
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS945-L207Q00000X
FLTRN 23754207Q00000X
MS390200000X
FLME137042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03553090Medicaid